T三维成像精确定位卵圆孔行射频热凝术治疗原发性三叉神经痛的疗效分析

目的:探讨经CT三维成像精确定位卵圆孔在原发性三叉神经痛射频热凝治疗中的应用,评价其近、中期临床有效率和安全性。方法:30例原发性三叉神经痛患者。穿刺前,行CT扫描和三维重建,通过计算机测量以明确穿刺方向和深度,按Hartel前入路穿刺。穿刺后,再次通过三维CT扫描和三维重建以调整穿刺针的方向和深度,神经电生理测试定位明确卵圆孔位置,穿刺卵圆孔定位成功后,行射频温控热凝术,观察术后近期临床疗效和并发症并对中期疗效进行随访。结果:术中所有患者穿刺均成功,术后全部患者疼痛缓解,近期疼痛缓解程度和有效率随时间增加,无严重并发症发生。术后1年随访27例,有效率为88.89%,1例复发,占3.70%。结论:经CT三维成像精确定位卵圆孔提高了穿刺的成功率和精确性,增加了操作的安全性,降低了并发症的发生。

The effect of radiofrequency thermocoagulation through 3dimensional-CT imaging precisely locating the foramen ovale in the treatment of primary trigeminal neuralgia

Objective:To observe the clinical effect of radiofrequency thermocoagulation(RFT) through 3 dimensional(3D)-CT imaging precisely locating the foramen ovale in the treatment of primary trigeminal neuralgia(PTN),and to evaluate efficiency and safety of this technique.Method:A total of 30 cases with PTN were involved in this study.Before puncturing,through CT scan and 3D-CT reconstruction,as well as computer measurement,the direction and depth of foramen ovale could be made clearly;then according to Hatel anterior approach punctured.After puncturing,the position of foramen ovale was make sure again by using CT scan and 3D-CT reconstruction again in order to adjust the direction and depth of puncture needle.Then electric stimulation was applied through radiofrequency electrode needle,by the sensory or motor nerve response the location of oval foramen could be determined.After successful positioning oval foramen,RFT was performed.The short-term clinical effect and complication were observed post-treatment,the mid-term effect was assessed in follow-up.Result:All punctures were successfully performed.After treatment,all patients had pain relief,the pain relief rate and the efficiency rate gradually increased with the time prolongation,no serious complication occurred.In all of the patients,27 cases were involved in the follow-up survey 1 year after treatment,the efficiency rate was 88.89%,1 patient recurred,the recurrence rate was 3.70%.Conclusion:The 3D-CT imaging could located the foramen ovale precisely,so the puncture and RFT were accurate,safe and successful,and the incidence rate of complication was less.